Table 1.
Benefit using 68Ga-PSMA ligand PET/CT | Patient group |
---|---|
High estimated benefit/diagnostic gain | • Primary staging in high-risk disease according to D’Amico classification • Biochemical recurrence with low PSA-values (0.2 ng/ml to 10 ng/ml)a |
Low estimated benefit/diagnostic gain | • Primary staging in low-risk (and intermediate-risk) disease according to D’Amico classification |
Potential application with promising preliminary data | • Biopsy targeting after previous negative biopsy, but high suspicion of PC (esp. in combination with multiparametric MRI using PET/MRI) |
Potential application with current lack of published data | • Monitoring of systemic treatment in metastatic CRPCb
• Monitoring of systemic treatment in metastatic castration-sensitive PCb • Active surveillance (esp. in combination with multiparametric MRI using PET/MRI) • Treatment monitoring in metastatic castration-resistant PC undergoing radioligand therapy targeting PSMA (e.g. 177Lu-PSMA-ligand) |
ain biochemical recurrence with PSA-values over 10 ng/ml conventional imaging (e.g. CT, MRI, bone scan) is also able to demonstrate distribution of disease. Furthermore, at PSA-values > 10 ng/ml salvage options facilitated by 68Ga-PSMA ligand PET/CT are unlikely
bMonitoring of treatment in metastasized PC patients might be enhanced due to often limited applicability of RECIST 1.1 criteria (e.g. non-target lymph node/bone metastases without extra-osseous extension) and the ineffectiveness of bone scan to reliably proving therapy response (e.g. flare phenomenon) compared to preclinical data suggesting PSMA-expression as indicator for response assessment